Individual
SHARON WISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22757 72ND AVE S, STE 102, KENT, WA 98032-2459
(253) 872-4118
Mailing address
20223 9TH AVE S, DES MOINES, WA 98198-3432
(206) 878-8458
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA
CREDENTIALS
WA
Enumeration date
08/30/2006
Last updated
07/08/2007
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